SCHWELB, Associate Judge.
Battalion Chief Stephen P. Lamphier of the District of Columbia Fire Department (DCFD) has asked this court to review a decision of the District of Columbia Police and Firefighters’ Retirement and Relief Board (the Board) denying his claim for benefits at the special pension rate available to a member who has been forced to retire on account of a service-related injury.
See
D.C.Code § 4-616 (1994). It is undisputed that Chief Lamphier is permanently disabled with a functional impairment of 10%, but the Board found no substantial evidence that any of several work-related injuries caused his condition. Chief Lamphier contends that the Board’s decision is not supported by substantial evidence in the record as a whole and that the Board applied an incorrect legal standard. We agree and reverse.
I.
THE FACTS
On June 22, 1995, the Board conducted an evidentiary hearing and heard testimony from Chief Lamphier and from Alexander Ukoh, M.D., a member of the Board of Surgeons of the Police and Fire Clinic. The testimony of these two witnesses was uncon-tradicted and was supplemented by medical records as summarized below.
A.
Chief Lamphier’s injuries.
Chief Lamphier, who is fifty-five years old, joined the DCFD in 1964, at the age of 22. He was subsequently promoted to Battalion Chief. At the time of the hearing before the Board, he had served as a firefighter for more than thirty years. The record discloses that during his long career, Chief Lamphier suffered several work-related injuries to his neck. We outline them in chronological order.
On September 23, 1971, while Chief Lam-phier was on duty, the springs of the door of a fire truck malfunctioned and struck Lam-phier on the head, knocking him unconscious. When he regained consciousness at the hospital, medical personnel told him that they suspected that his neck was broken. Lam-phier was immobilized, placed in a neck brace, and tied to the bed. Although it was subsequently ascertained that Chief Lamphier’s neck was not broken, he continued to report soreness for some time. Chief Lam-phier remained in the hospital for two nights, but he was released after he had been examined by a neurosurgeon. He missed one week of work.
On June 27, 1985, Chief Lamphier was on duty when a ceiling collapsed on him. He suffered injuries to his neck and shoulders. He was placed on sick leave, and resumed duty one week later, on July 4,1985.
On April 2,1993, Chief Lamphier fell while on duty. He injured his neck and right shoulder. He was treated and placed on sick leave. He returned to light duty on May 3, 1993, and to full duty six days later.
On April 11, 1994, Chief Lamphier was injured when he fell down an unlighted staircase while responding to a call. He aggravated his neck condition and injured his right shoulder. He has been unable to return to work since this incident.
Chief Lamphier also suffered serious injuries in an off-duty automobile accident which occurred on November 10, 1979. Although the Board was hampered in the evaluation of
this incident by the unavailability of some relevant records, it appears that Chief Lam-phier suffered a fractured skull, a cerebral concussion, and possible intra-cranial bleeding. As a result of this accident, Chief Lam-phier was on sick leave for two months and five days, and subsequently on light-duty for some undisclosed additional period of time.
B.
The medical testimony.
Dr. Ukoh testified that Chief Lamphier suffers from degenerative disc disease, an arthritic condition. He explained that there are three categories of arthritis:
1. familial or inherited arthritis;
2. arthritis incurred solely through the aging process; and
3. arthritis resulting from trauma.
According to Dr. Ukoh, Chief Lamphier’s arthritis was not inherited or familial for, if it had been, “he would have had it at a younger age.” Turning to the second category, Dr. Ukoh stated: “I cannot tell you for sure that what you find in his neck [is] a result of his age.” In spite of the indefiniteness of this assessment, Dr. Ukoh then stated, in response to a question from a member of the Board, that “I will have to put it on trauma.” He explained that “[i]n the presence of trauma to the particular region, and you find this degeneration subsequently, I have to tie it into the trauma more than normal.” Asked whether “daily wear and tear” was a factor, Dr. Ukoh responded:
I wouldn’t lump everything all together. I wouldn’t lump normal daily wear and tear along with the known significant injuries to the area that I have [mentioned],
I would restrict everything to the injuries and not to normal, daily wear and tear.
(Emphasis added.)
Dr. Ukoh testified that Chief Lamphier’s condition resulted from the “cumulative” injuries to his neck. He stated that “[i]t’s difficult to pinpoint the ’71, ’79, or ’85, or ’87 [sic].[
] I would say it’s a combination of all of them.” He explained, however, that Chief Lamphier’s initial 1971 head injury was significant enough to have implicated the neck at that time. Asked by Chief Lamphier’s counsel to identify the injury that “started the ball rolling,” Dr. Ukoh responded: “From what I see on the record now, the first initial injury that is related to the neck was the ’71 injury. The first initial one.”
Dr. Ukoh made it clear that, in his opinion, Chief Lamphier’s condition was not initially brought about by Lamphier’s fall in April 1994. He so concluded because the bulge in the disc represented “degenerative changes that occurred over the years. It doesn’t happen acutely, as we all know.” When Dr. Ukoh was asked whether the incident in June 1985 (when a ceiling fell on Chief Lam-phier) was a “pre-existing cause of those x-ray findings,” Dr. Ukoh responded that “it is reasonable to expect that the injury of January 1985[
] and the injury of June 1985 would lead to the development of what you’re seeing at this time.”
Dr. Ukoh was also questioned about Chief Lamphier’s 1979 off-duty automobile accident. He testified that he did not have all “of the records and facts about the ’79 injury” and that it was difficult for him to compare the consequences of that accident with Chief Lamphier’s 1971 incident. Dr. Ukoh
was of the opinion that, both in 1971 and in 1979, the trauma to Chief Lamphier’s head implicated his neck as well. He believed that the 1979 incident and the other traumas suffered by Chief Lamphier “were all combined to play a role” in the patient’s condition. Dr.
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SCHWELB, Associate Judge.
Battalion Chief Stephen P. Lamphier of the District of Columbia Fire Department (DCFD) has asked this court to review a decision of the District of Columbia Police and Firefighters’ Retirement and Relief Board (the Board) denying his claim for benefits at the special pension rate available to a member who has been forced to retire on account of a service-related injury.
See
D.C.Code § 4-616 (1994). It is undisputed that Chief Lamphier is permanently disabled with a functional impairment of 10%, but the Board found no substantial evidence that any of several work-related injuries caused his condition. Chief Lamphier contends that the Board’s decision is not supported by substantial evidence in the record as a whole and that the Board applied an incorrect legal standard. We agree and reverse.
I.
THE FACTS
On June 22, 1995, the Board conducted an evidentiary hearing and heard testimony from Chief Lamphier and from Alexander Ukoh, M.D., a member of the Board of Surgeons of the Police and Fire Clinic. The testimony of these two witnesses was uncon-tradicted and was supplemented by medical records as summarized below.
A.
Chief Lamphier’s injuries.
Chief Lamphier, who is fifty-five years old, joined the DCFD in 1964, at the age of 22. He was subsequently promoted to Battalion Chief. At the time of the hearing before the Board, he had served as a firefighter for more than thirty years. The record discloses that during his long career, Chief Lamphier suffered several work-related injuries to his neck. We outline them in chronological order.
On September 23, 1971, while Chief Lam-phier was on duty, the springs of the door of a fire truck malfunctioned and struck Lam-phier on the head, knocking him unconscious. When he regained consciousness at the hospital, medical personnel told him that they suspected that his neck was broken. Lam-phier was immobilized, placed in a neck brace, and tied to the bed. Although it was subsequently ascertained that Chief Lamphier’s neck was not broken, he continued to report soreness for some time. Chief Lam-phier remained in the hospital for two nights, but he was released after he had been examined by a neurosurgeon. He missed one week of work.
On June 27, 1985, Chief Lamphier was on duty when a ceiling collapsed on him. He suffered injuries to his neck and shoulders. He was placed on sick leave, and resumed duty one week later, on July 4,1985.
On April 2,1993, Chief Lamphier fell while on duty. He injured his neck and right shoulder. He was treated and placed on sick leave. He returned to light duty on May 3, 1993, and to full duty six days later.
On April 11, 1994, Chief Lamphier was injured when he fell down an unlighted staircase while responding to a call. He aggravated his neck condition and injured his right shoulder. He has been unable to return to work since this incident.
Chief Lamphier also suffered serious injuries in an off-duty automobile accident which occurred on November 10, 1979. Although the Board was hampered in the evaluation of
this incident by the unavailability of some relevant records, it appears that Chief Lam-phier suffered a fractured skull, a cerebral concussion, and possible intra-cranial bleeding. As a result of this accident, Chief Lam-phier was on sick leave for two months and five days, and subsequently on light-duty for some undisclosed additional period of time.
B.
The medical testimony.
Dr. Ukoh testified that Chief Lamphier suffers from degenerative disc disease, an arthritic condition. He explained that there are three categories of arthritis:
1. familial or inherited arthritis;
2. arthritis incurred solely through the aging process; and
3. arthritis resulting from trauma.
According to Dr. Ukoh, Chief Lamphier’s arthritis was not inherited or familial for, if it had been, “he would have had it at a younger age.” Turning to the second category, Dr. Ukoh stated: “I cannot tell you for sure that what you find in his neck [is] a result of his age.” In spite of the indefiniteness of this assessment, Dr. Ukoh then stated, in response to a question from a member of the Board, that “I will have to put it on trauma.” He explained that “[i]n the presence of trauma to the particular region, and you find this degeneration subsequently, I have to tie it into the trauma more than normal.” Asked whether “daily wear and tear” was a factor, Dr. Ukoh responded:
I wouldn’t lump everything all together. I wouldn’t lump normal daily wear and tear along with the known significant injuries to the area that I have [mentioned],
I would restrict everything to the injuries and not to normal, daily wear and tear.
(Emphasis added.)
Dr. Ukoh testified that Chief Lamphier’s condition resulted from the “cumulative” injuries to his neck. He stated that “[i]t’s difficult to pinpoint the ’71, ’79, or ’85, or ’87 [sic].[
] I would say it’s a combination of all of them.” He explained, however, that Chief Lamphier’s initial 1971 head injury was significant enough to have implicated the neck at that time. Asked by Chief Lamphier’s counsel to identify the injury that “started the ball rolling,” Dr. Ukoh responded: “From what I see on the record now, the first initial injury that is related to the neck was the ’71 injury. The first initial one.”
Dr. Ukoh made it clear that, in his opinion, Chief Lamphier’s condition was not initially brought about by Lamphier’s fall in April 1994. He so concluded because the bulge in the disc represented “degenerative changes that occurred over the years. It doesn’t happen acutely, as we all know.” When Dr. Ukoh was asked whether the incident in June 1985 (when a ceiling fell on Chief Lam-phier) was a “pre-existing cause of those x-ray findings,” Dr. Ukoh responded that “it is reasonable to expect that the injury of January 1985[
] and the injury of June 1985 would lead to the development of what you’re seeing at this time.”
Dr. Ukoh was also questioned about Chief Lamphier’s 1979 off-duty automobile accident. He testified that he did not have all “of the records and facts about the ’79 injury” and that it was difficult for him to compare the consequences of that accident with Chief Lamphier’s 1971 incident. Dr. Ukoh
was of the opinion that, both in 1971 and in 1979, the trauma to Chief Lamphier’s head implicated his neck as well. He believed that the 1979 incident and the other traumas suffered by Chief Lamphier “were all combined to play a role” in the patient’s condition. Dr. Ukoh noted, however, that following the 1971 fire truck incident, Chief Lamphier had subjective complaints regarding his neck, whereas after the 1979 car accident, he had none.
II.
THE BOARD’S DECISION
On September 26,1995, the Board issued a written order disposing of Chief Lamphier’s claim. The Board found that Chief Lamphier is “permanently disabled as a result of cervical disc disease ... that precludes Member from performing useful and efficient service in any duty status.” The Board noted Dr. Ukoh’s testimony that Chief Lamphier had weakness in his right arm and constant pain radiating down that arm.
The Board then turned to the question whether Chief Lamphier’s condition was service-related. After a somewhat selective recitation of the facts,
the Board found, in pertinent part, as follows:
In Dr. Ukoh’s opinion all of the incidents play a “role” in the problems in Member’s
neck, but he cannot point to any one cause or say that Member is disabled because of any particular incident. In fact, the logical conclusion from Dr. Ukoh’s testimony is that Member’s condition could have started from an incident not in the record; or which predated even the 1971 injury. Dr. Ukoh believes that Member’s degeneration is not inherited and is unsure if it is caused by age. Therefore, Dr. Ukoh testified that he “would
have to
put it on trauma” (emphasis added). This is guessing! However, several minutes later, Dr. Ukoh’s ambiguity in the support or lack of support for this “guess,” surfaces again when he states that,
I’m not saying that the 1971 injury by itself alone was the cause of the arthritis or the accumulative injury to the neck would be responsible for the findings that we’re seeing now.[
]
In the absence of a more definitive medical finding, the Board is unwilling to
place
the cause on trauma. The Board must base its findings on substantial evidence. Neither Dr. Ukoh’s testimony, nor the Member’s testimony has proven by a substantial weight of the evidence that trauma from an on-duty injury caused member’s present degenerative cervical disease.
Finding No. 2 (emphasis in original) (citations to the record omitted). The Board then reasoned as follows in its Conclusions of Law:
Neither Dr. Ukoh’s testimony, nor the Member’s testimony has proven by a substantial weight of the evidence[
] that trauma from an on-duty injury caused Member’s present discomfort. There are no objective tests, the results of which warrant placing the cause of Member’s neck problems on on-duty trauma. Thus, based on the record and the facts in finding two above, the Board finds that Member’s disabling condition was not incurred in the performance of duty within the meaning of
D.C.Code § 4.-6I6 (1981).
Therefore, the Board concludes that Member’s disability was incurred other than in the perfor-manee of duty,
D.C.Code § 4-615 (1981).
Chief Lamphier filed a timely petition
for
review.
III.
LEGAL DISCUSSION
Paraphrasing
Baumgartner v. Police & Firemen’s Retirement & Relief Bd.,
527 A.2d 313 (D.C.1987), “[t]he issue before the Retirement Board was whether [Chief Lamphier’s] on-duty injuries] and the subsequent aggravations caused his permanent disability, which would entitle him to retire under D.C.Code Sec. 4-616(a), or whether [aging or] his off-duty [1979] injury was the root cause of all his [arthritic] problems, which would give him a reduced pension under D.C.Code See. 4-615(a).”
Id.
at 315. Chief Lamphier contends that the Board’s findings are
not
supported by substantial evidence and that its legal conclusions are erroneous. We agree.
The applicable standard of review is now familiar. Whether Chief Lamphier’s arthritic condition is the result of one or more injuries incurred during the performance of duty is an issue of fact.
Croskey v. District of Columbia Police & Firefighters’ Retirement & Relief Bd.,
596 A.2d 988, 990 (D.C.1991). We may set aside the Board’s findings only if they are unsupported by substantial evidence in the record.
See Allen v. District of Columbia Police & Firefighters’ Retirement & Relief Bd.,
528 A.2d 1225, 1229 (D.C.1987). If a finding is supported by substantial evidence, then the court must accept it, even though there may also be substantial evidence in the record to support a contrary finding.
Szewczyk v. District of Columbia Police & Firefighters Retirement & Relief Bd.,
633 A.2d 1 (D.C.App.1993) (per curiam).
Under the “substantial evidence” standard, the Board must
(1) state findings of fact on each material, contested factual issue, (2) base such find
ings on substantial evidence, or (3) draw conclusions of law which follow rationally from the findings. Substantial evidence in this context is “ ‘more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.’ ”
Allen, supra,
528 A.2d at 1229 (citations omitted);
see also DiVincenzo v. District of Columbia Police & Firefighters Retirement & Relief Bd.,
620 A.2d 868, 872 (D.C.App. 1993). The Board is required to consider all of the evidence and to “make a meaningful attempt to come to grips with the difficult factual issues raised by this record.”
DiVincenzo, supra,
620 A.2d at 872 (citation omitted).
The assignment of the burden of proof is also familiar. In a case such as this one, in which Chief Lamphier is claiming that he became disabled as the result of a work-related aggravation of a pre-existing condition, he must show by a preponderance of the evidence that the initial condition was related to the performance of his duties.
See, e.g., Croskey, supra,
596 A.2d at 991-92 (“[t]he ultimate burden of persuasion remain[s] with [the person claiming entitlement to a special pension rate pursuant to Section 4-616(a) ]”);
Kirkwood v. District of Columbia Police & Firemen’s Retirement & Relief Bd.,
468 A.2d 965, 969 (D.C.1983).
A claimant seeking benefits under section 4-616(a) bears the initial burden of producing evidence that the disabling injury was incurred in the performance of duty. If the claimant makes a showing of a service incurred injury, the opposing side must then offer evidence disproving the logical inference that the ensuing disability was the long term result of such injury. In other words, once the claimant makes a showing of a disabling on-duty injury, the burden shifts to the government, which must then rebut this logical inference with substantial evidence ... disproving] the inference of causation by an on-duty injury- If the government’s proof is defi-eient, the claimant is entitled to rely on the logical inference that his or her disability was the result of the proven on-duty injury.
Baumgartner, supra,
527 A.2d at 315 (footnote, citations, and internal quotation marks omitted).
We entertain no doubt that Chief Lamphier satisfied his initial burden. He presented evidence that both the initial injury in 1971 and the final aggravating injury in 1994 were incurred in the performance of duty. Indeed, it is undisputed that Chief Lamphier suffered at least five traumas affecting his neck, of which four occurred while he was on the job. The possibility that all of these traumatic events were unrelated to Chief Lamphier’s degenerative disc disease was not a compelling one.
Dr. Ukoh, the sole medical witness who appeared before the Board, testified in substance that although arthritis from aging alone could not be ruled out, Chief Lamphier’s condition was probably traumatic in origin. He opined that the 1971 accident, in which a broken neck was initially suspected, the patient’s neck had to be immobilized, and subjective complaints of neck pain followed, probably “started the ball rolling.”
Dr. Ukoh also found a logical association between Chief Lamphier’s condition and the Chiefs 1985 encounter with a falling ceiling. Unsurprisingly, Dr. Ukoh did not attribute to coincidence Chief Lamphier’s development of an arthritic condition in the area of his body affected by several traumatic injuries. Cf
. Poulnot v. District of Columbia,
608 A.2d 134, 139 (D.C.1992) (coincidences not presumed). Chief Lamphier thus produced evidence which, unless effectively rebutted, established that the disabling injury was incurred in the performance of duty.
See Baumgartner, supra,
527 A.2d at 315.
There was no effective rebuttal to the claimant’s
prima facie
case. The Board appeared to attach a great deal of significance
to Chief Lamphier’s 1979 automobile accident. Indeed, Dr. Ukoh testified that this accident, together with the other traumas to Chief Lamphier’s neck, contributed to his disabling condition. There was no testimony before the Board, however, to suggest that the 1979 accident was the sole cause, or even the principal cause, of the Chiefs arthritis.
Further, according to the Board, “the logical conclusion from Dr. Ukoh’s testimony is that Member’s condition could have started from an incident not in the record, or one which predated even the 1971 injury.” This assertion is entirely speculative. Although the scenario suggested by the Board is not technically impossible — we cannot know what may or may not have happened to Chief Lamphier, or what might have developed in his body, on occasions not addressed in the record — the only reasonable inference from Dr. Ukoh’s testimony is that Chief Lamphier’s condition resulted from a combination of traumatic incidents, all but one of which occurred on duty, and that an “on-duty” accident aggravated a condition initially caused by the earlier “on-duty” accident which had set these events in motion. The District government has not presented substantial evidence to the contrary, and we therefore hold that the Board’s decision cannot stand.
IV.
CONCLUSION
For the foregoing reasons, we conclude that Chief Lamphier is entitled to retire at the special pension rate set forth in D.C.Code § 4-616. The decision of the Retirement Board is reversed, and the case is remanded to the Board for further proceedings consistent with this opinion.
So ordered.